WASHINGTON — Patients with ulcerative colitis treated with Entyvio had higher remission rates compared with patients treated with TNF antagonists, according to research presented at Digestive Disease Week.
David Faleck, MD, of the Icahn School of Medicine at Mount Sinai, reported that Entyvio (vedolizumab, Takeda) effectively treated patients with moderate-to-severe active ulcerative colitis who failed or were intolerant to conventional therapy or TNF antagonists.
“We’ve seen in clinical practice that prior exposure to anti-TNF therapy is a predictor of reduced vedolizumab effectiveness,” he said during his presentation. “As is the case with much of IBD literature, we have no randomized head-to-head trials of these two agents or classes, which complicates comparison.”
To compare the effectiveness of vedolizumab with anti-TNF therapies in the treatment of UC, Faleck and colleagues analyzed data from a multicenter cohort of patients treated for UC between 2014 and 2017. They performed propensity score matching with a 1:1 ratio accounting for age, sex, prior UC-related hospitalization within the previous year, disease extent, disease severity, steroid refractoriness or dependence, and prior TNF-antagonist failure. Then, they compared cumulative rates of clinical remission, steroid-free remission and endoscopic healing.
Researchers included 334 patients after matching (49% men; median age, 36 years) and assigned the patients 1:1 to either vedolizumab (n = 167) or anti-TNF therapy (n = 167).
Faleck and colleagues found that the vedolizumab cohort had higher rates of clinical remission (54% vs. 37%; adjusted HR = 1.54; 95% CI, 1.08–2.18) and endoscopic healing (50% vs. 42%; aHR= 1.73; 95% CI, 1.1–2.73) compared with the anti-TNF group after 12 months of treatment. Steroid-free remission rates were also higher in the vedolizumab group (49% vs. 38%; aHR = 1.43; 95% CI, 0.79–2.6), but not statistically different, Faleck said.
Faleck said that further research is needed to confirm their findings.
“Of course, the gold standard of randomized controlled trial data are needed to confirm these findings and determine the optimal position of vedolizumab in current treatment algorithms,” he said. – by Alex Young
Faleck D, et al. Abstract 328. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.
Faleck reports no relevant financial disclosures. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.